Emergency departments see rise in flu-like illness

Feb 24, 2010 (CIDRAP News)  Some of the nation's emergency departments are noting increases in flu-like illness cases that appear to be pandemic H1N1, and colleges are reporting the first increase in flu-like illness since the end of November, but it's not clear if these are early signs of a third pandemic flu wave.

The American College of Emergency Physicians (ACEP) said today in a Twitter post that some of its members were anecdotally reporting a new wave of pandemic H1N1 patients coming to emergency departments and asked if other physicians were seeing similar patterns.

Carl Schultz, MD, professor of emergency medicine at the University of California at Irvine, told CIDRAP News that the increase in the number of influenza-like illnesses appears to be real, but he cautioned that many of the cases have not been confirmed as the pandemic H1N1 strain, because many departments stopped specifically testing for it because of low flu activity. Schultz chairs ACEP's disaster preparedness and response committee.

Schultz cautioned that the apparent increase in flu activity could be an aberration, and he added that there have been no official reports of increases in hospitalizations and deaths from flu-like illnesses. Though he said the uptick in flu-like illnesses could be from seasonal flu, the likelihood may be less, because seasonal flu usually starts in November and peaks in January and February.

"To see something rising this late would be unusual," Schultz said, adding that the pandemic H1N1 virus has not observed typical flu season patterns. He said physicians are waiting to see if the pattern they're seeing is just a blip or if it turns out to be a real spike in pandemic H1N1 activity.

Tom Skinner, a spokesman for the US Centers for Disease Control and Prevention (CDC) said today that the CDC has nothing to report on any increase in flu activity, but he said it is keeping watch of flu-like illness trends across the nation.

Meanwhile, the American College Health Association (ACHA) today reported in its latest surveillance summary of influenza-like illnesses a 52% rise in cases, reflecting the first increase since the end of November. For the week ending Feb 19, the attack rate at schools was 4.1 cases per 10,000 students. The ACHA said some colleges in the southeast and Midwest have reported slight increases in disease activity.

Schultz said that the rise in college flu-like illnesses isn't particularly alarming, because activity had dropped to such a low level that a 52% increase is not sizeable.

So far this week no states have reported an increase in flu activity. A spokesman for the Washington State Department of Health said today that pandemic H1N1 cases have slowed but not disappeared, the Associated Press (AP) reported today. Five more people were hospitalized for H1N1 infections over the past week, but no new deaths have been reported.

Minnesota health officials today reported that flu activity remained low, with one school reporting an influenza-like illness outbreak, no new deaths, and no outbreaks at long-term care facilities.

The CDC is still urging all groups, especially those at high risk for complications such as pregnant women and those with underlying health conditions, to get vaccinated against pandemic H1N1 flu, especially now that vaccine supplies are plentiful. The CDC is also reminding parents of children younger than 10 who have already received one dose of the vaccine that the youngsters need a second dose for optimal protection.